Kenneth Roy
The all-night conversation

This is not about money. It was never about money. It becomes clear, if it was not clear before, what is going on in the muddled heads of the people who run NHS Greater Glasgow and Clyde; it is apparent now what inspires their decision to withdraw £1.2 million a year of funding from St Margaret of Scotland Hospice.
     To these people, £1.2 million a year is petty cash. I could save it for them tomorrow. I have studied their accounts years back. I would know where to start.
     They are not killing the hospice or turning it into an old people's home (it amounts to the same thing) to save money. No, no. They are actually trying to make a point. They are setting out their philosophy. Well, that is rather a grand word with which to dignity their foolish schemes, but it will do.
     The clue lies in one sentence of a recent letter from the chairman of NHS Greater Glasgow and Clyde, Andrew Robertson. You can safely assume that its recipient was not the editor of the Scottish Review.
     Here is the sentence:
     'As you will be aware there is a marked move away from large numbers of in-patient accommodation. The emphasis is progressively towards encouraging independent living and hospice care at home'.
     As you will be aware
     I confess that I am not aware. Is the public of Scotland aware? Are the terminally ill aware? Who is aware outside the tiny circle of bureaucrats who are invariably 'aware'?
     A marked move away...
     Among whom has this move been marked? Is this the policy of the Scottish Government? What does Nicola Sturgeon have to say about it as the cabinet secretary for health? What does Dr Kevin Woods, the director-general for health, have to say about it? Let's have a national debate on the care of the dying; let's challenge the lot of them to defend this marked move away.
     Large numbers of in-patient accommodation
     A phrase so woolly, so unspecific, that it is meaningless. Large numbers of accommodation – does it even make sense as a term?
     Progressively towards...
     At the risk of standing language on its head, I would rather in this case we moved regressively towards...
     ...independent living and hospice care at home
     Ah. Suddenly the chairman gives the game away.

Five weeks into this Scottish Review investigation, Mr Robertson has compelled me with a single sentence to show how flawed and impracticable is the policy of his board. I will show it in the telling of an anecdote and I promise not to bore you with large numbers of in-patient accommodation. The numbers involved are small. The accommodation is intimate. I will take you to a hospice.
     Many years ago, I started and ran a radio station. I was interested only in news and current affairs, but I supposed that we must have some music too, ghastly as the prospect was, so I hired one or two people to play records (as they were called). Allan was among the original DJs. We had no records and he had thousands. He let us have the run of his collection and presented his own programme on a Sunday morning. Quite a while after both of us had left the radio station, a friend of his called out of the blue and said that Allan was dying and that he would like to see me. I went on seeing him, at home and in Strathcarron Hospice – he moved from one to the other, back and forth, as his condition changed – every Thursday afternoon for several months. I would go either to his parents' house near Falkirk or to the hospice.
     Always, from the first time I saw him again, he looked terribly ill and it was obvious to anyone that his elderly parents were incapable of looking after him for any sustained period. And, of course, he knew he was dying. He talked about the prospect of death openly. I sensed from the start that the availability of the hospice was a – I was going to call it a lifeline – I will call it a lifeline – as well as a profound comfort. He knew it was there for him. The bed was waiting.
     His powers of survival were astonishing. He defied every prognosis. Days turned to weeks, weeks to months. He confided to me why. He said he was waiting for Princess Anne.
     'Princess Anne?'
     'She's the patron and she's coming in July. I'll stay alive for her.'      Princess Anne had become a reason to go on living. I was to put the date in my diary; I was to meet her; and then, and only then, would he go. The two of us – Princess Anne and I – stood one summer's day at the head of Allan's bed. I liked her at once. She was brisk and cheerful; a good sort. Within days Allan was gone. Just as he had promised.
     But not before he told me something that, had I the ability to write fiction, I would turn into a script.
     There was a communal sitting room in the hospice. Regularly, some of the dying – the number varied – would gather for an all-night conversation. A conversation without agenda, without limits, without end – about everything in heaven and earth; about living and dying; about death and what, if anything, happens next. In the years since Allan's death I have wondered about these gatherings. He said they were notable for their emotional candour, their humour, above all their conquering of fear. All my journalistic instincts failed me: I kept urging myself to probe further, to ask Allan for examples of what was said, but better instincts prevailed. I never did. I feel sure they were remarkable in their humanity at an hour of deepest need. The yearning for a sense of community, something to give meaning to our lives, was there at the end.

Now we have Andrew Robertson lauding the concepts of 'independent living' and 'hospice care at home'.
     Allan in his final weeks was incapable of living independently. He would not have wished to live independently even if it had been within his capacity to do so. He wished to be part of the hospice community. He wished to die with others. He wished the solace of the all-night conversation. I believe that his only fear, apart from the distress that would have been caused to his elderly parents by dying at home, was dying alone. I believe there are many like him. They may even be a majority.
     And so I see now what I did not see even a few days ago: that, at the bottom of NHS Greater Glasgow and Clyde, there is not only an abject failure of policy and principle, but a failure to understand who we are, and how we operate, as human beings.